Efficacy and safety of tranexamic acid on perioperative blood loss in total knee arthroplasty.

Abstract

Objective To investigate the efficacy and safety of tranexamic aeid on perioperative blood loss associated with total knee arthroplasty(TKA). Methods From May 2008 to February 2009, 98 pa-tients (35 males, 63 females) underwent TKA, 66 cases with osteoarthritis, 32 with rheumatoid arthritis. The course of illness ranged from 2 to 12 years (mean, 5 years). They were randomly divided into Group A and B with 49 patients each. The patients in Group A received tranexamic acid, and the patients in Group B re-ceived an equal volume of normal saline, in Group A, 1 g of tranexamic acid dissolved in 250 ml of normal saline was intravenously infused before deflation of the tourniquet; another intravenous administration of the same drug of the same dosage was given 3 h later. In Group B, only 250 ml of normal saline was infused in-travenously. The amounts of intraoperative blood loss, postoperative wound blood loss and blood transfusion,the number of the patients needing blood transfusion and the value of postoperative hemoglobin concentration of all patients were recorded. Fibrinogen, prothrombin time, and activated partial thromboplastin time were also examined before operation, during operation (deflation of the tourniquet), and 3 hours after operation.And they were also observed for whether they had deep vein thrombosis and both lower limbs of all patients were examined by the color Doppler uhrasonography 14 days after operation. Results There was no signifi-cant difference in intraoperative blood loss botween two groups(P >0.05). There were significant differences in the amount of postoperative wound blood loss, blood transfusion, the number of the patients needing blood transfusion and the value of postoperative hemoglobin concentration between two groups, Group A were lower than Group B (P 0.05). And no deep vein thrombosis was found 14 days after operation. Conclusion During and after the TKA, a short-term use of tranexamic acid can significantly decrease blood loss and blood transfusion without increasing risk for venous thrombosis. Key words: Arthrnplasty; replacement; knee; Tranexamic acid; Blood loss; surgical